Individual provider Active NPI

Susan Jane Aycock, CRNA

  • Certified Registered Nurse Anesthetist
  • Slidell, LA
National Provider Identifier
1003819533
Registry record updated Feb 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
RN064988 Issued in LA
Practice address
1001 Gause Blvd
Slidell, LA 70458-2939
Phone
(985) 649-8767
NPI assigned
May 30, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X RN064988 LA Primary

Addresses

Primary practice location

1001 Gause Blvd
Slidell, LA 70458-2939

Mailing address

120 Innwood Dr
Covington, LA 70433-9123
Phone (985) 892-3225

Other identifiers 1

IdentifierTypeStateIssuer
1650668MedicaidLA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA, MS, WV, NC4 enrollments

Enrollment records 4

Enrollment IDStateProvider typePAC IDDetails
I20101203000318 LA Practitioner - Certified Registered Nurse Anesthetist (Crna) 2264629211 Reassigns benefits to 5 organizations
I20230302000635 MS Practitioner - Certified Registered Nurse Anesthetist (Crna) 2264629211 Reassigns benefits to 1 organization
I20240531002170 WV Practitioner - Certified Registered Nurse Anesthetist (Crna) 2264629211 Reassigns benefits to 1 organization
I20250213003051 NC Practitioner - Certified Registered Nurse Anesthetist (Crna) 2264629211 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Anesthesiology Affiliates LLCGroup PAC ID 6800936162, 39 clinicians

Practice addresses (Care Compare)

131 Cherokee Rose LN
Covington, LA 70433-7244
Phone (985) 871-1721

Merit-based Incentive Payment System (MIPS)

Final score
95.34 of 100Reported as apm
Quality
79.86
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7602NCMDPharmacist
RN064988LAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Jefferson Anesthesia Consultants CurrentSince Jan 13, 2026 Accepting new patients
Zephyr Anesthesia, LLC Nurse Anesthetist, Certified Registered CurrentSince Mar 22, 2023 Accepting new patients
CHS Anesthesia Services Group Inc CurrentSince Jan 6, 2025 Accepting new patients
West Virginia University Medical Corporation CurrentSince Apr 23, 2024 Accepting new patients
West Virginia University Medical Corporation CurrentSince Apr 23, 2024 Accepting new patients
Galleria Anesthesia Associates, LLC CurrentSince Mar 1, 2025 Accepting new patients
Anesthesiology Affiliates, LLC Nurse Anesthetist, Certified Registered CurrentSince Jun 1, 2023 Accepting new patients

Locations

9103 Jefferson Hwy
Baton Rouge, LA 70809
Phone (225) 927-1190

131 Cherokee Rose Ln
Covington, LA 70433
Phone (985) 641-8982

4407 Highway 190 East Service Rd
Covington, LA 70433
Phone (985) 234-9700

67252 Industry Ln
Covington, LA 70433
Phone (985) 801-0259

694 Belle Terre Blvd
La Place, LA 70068
Phone (985) 359-6694

1717 Saint Charles Ave
New Orleans, LA 70130
Phone (504) 529-6600

2701 Napoleon Ave
New Orleans, LA 70115
Phone (504) 267-2805

58515 Pearl Acres Rd
Slidell, LA 70461
Phone (985) 641-8982

1 Medical Center Dr
Morgantown, WV 26506
Phone (304) 293-4500

Organizations & group practices 9

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1117411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739318400000",
    "number": "1003819533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 INNWOOD DR",
            "city": "COVINGTON",
            "state": "LA",
            "postal_code": "704339123",
            "telephone_number": "985-892-3225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 GAUSE BLVD",
            "city": "SLIDELL",
            "state": "LA",
            "postal_code": "704582939",
            "telephone_number": "985-649-8767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AYCOCK",
        "first_name": "SUSAN",
        "middle_name": "JANE",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-05-30",
        "last_updated": "2025-02-12",
        "certification_date": "2025-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "LA",
            "license": "RN064988",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1650668",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Slidell, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.